c—erbB-2、p53和nm23H1蛋白在肝外胆管癌组织中的表达及临床意义

目的探讨c—erbB-2、p53和nm23H1基因在肝外胆管癌发生与发展中的作用。方法用免疫组化法检测72份肝外胆管癌组织、43份癌旁胆管组织和11份正常胆管组织中c—erbB-2、p53和nm23H1蛋白表达情况，并分析三项指标与肝外胆管癌临床病理特征的相关性。结果p53蛋白表达阳性率胆管癌组织〉癌旁组织〉正常胆管组织（P〈0．05、0．01），且低分化者表达阳性率显著高于高分化和中分化者，Ⅲ～Ⅳ期者表达阳性率显著高于Ⅰ～Ⅱ期者，有转移者阳性表达率显著高于无转移者，生存时间≤18个月者显著高于〉18个月者（P〈0．05）；c—erbB-2蛋白表达阳性率胆管癌组织〉癌旁组织〉正常胆管组织（P〈0．05、0．01），其中低分化者显著高于高分化及中分化者，有转移者明显高于无转移者（P〈0．05）；nm23H1蛋白表达阳性率胆管癌组织〈癌旁组织〈正常胆管组织（P〈0．05、0．01），且低分化者显著低于高、中分化者，Ⅲ～Ⅳ期者表达阳性率显著低于Ⅰ～Ⅱ期者，生存时间≤18月者显著低于〉18月者。结论c—erbB-2、p53、nm23H1在胆管癌发生、发展中起重要作用，其中p53、nm23H1蛋白表达可反映胆管癌生物学行为和恶性程度，c-erbB-2蛋白过度表达与胆管癌分化程度有关。

The expression of c-erbB-2, p53 and the nm23H1 protein in the extrahepatic bile duct cancer tissue and its clinical significance

Objective To investigate the effects of c-erbB-2, p53 and nm23H1 gene in the pathogenesis and development of extrahepatic bile duct cancer. Methods The expression of c-erbB-2,p53 and nm25H1 protein were detected by using immunohistochemical method in 72 specimens of extrahepatic bile duct cancer tissue, adjacent bile duct tissue and normal bile duct tissue, and the correlation of those 3 indexes with the clinicopathological characteristics of extrahepatic bile duct cancer were analyzed. Results The positive expression rate of p53 protein in bile duct cancer tissue 〉 adjacent bile duct tissue 〉 normal bile duct tissue（ P 〈 0.05,0.01 ）, and the rate in cases of low differentiation , stage Ⅲ - Ⅳ, metastatic and survival time ≤18 months were higher than that in cases of high and middle differentiation,stagel-Ⅱ ,nonmetastatic and survival time 〉 18 months respectively（ P 〈0.05 ）. The positive expression rate of c-erbB-2 protein in bile duct cancer tissue 〉 adjacent bile duct tissue 〉 normal bile duct tissue（ P 〈 0.05,0.01 ）, and the rate in cases of low differentiation, metastatic were higher than that in cases of high and middle differentiation, nonmetastatic respectively（ P 〈 0.05 ）. The positive expression rate of nm23H1 protein in bile duct cancer tissue 〈 adjacent bile duct tissue 〈 normal bile duct tissue（P 〈 0.05,0.01 ）, and the rate in cases of low differentiation , stage Ⅲ - Ⅳ, and survival time ≤ 18 months were lower than that in cases of high and middle d/fferentiation,stagel -Ⅱ and survival time 〉 18 months respectively（P 〈0.05）. Conclusions e-erbB-2 ,p53 ,nm23H1 play important roles in the pathogenesis and development of bile duct cancer. The expression of p53 and nm23H1 protein can reflect the biological behaviour and grade malignancy of bile duct cancer,the overexpression of c-erbB-2 is correlated to differentiation of bile duct cancer.